Today I supervised one of my regulars for his exercise session. We have a really great rapport and talk pretty much non-stop from the minute he rolls in the door, which I was very grateful for today.... I went to see 'Mark' to start his PT and immediately I thought he seemed not quite himself. I asked if he was ready to got to the gym and he said something along the lines of "i'm having a bit of trouble, do you mind if we start a bit later, once i've sorted this out?" I thought he was a bit uncomfortable and I decided not to press him for answers or clarification. I had no idea what he was talking about. Instead I just accepted this and said no worries, I'll be in the physio area whenever you're ready.
After about 10 mins he appeared, saying he was very tired. He was getting a bit depressed about his situation, disability (Acute disseminated encephalomyelitis... good words for a spelling bee), recent broken ankle, how he ruined his life in his youth... I think I did the right thing by changing the subject to the Melbourne Cup/ Red Bull/ his church group/ anything other than his past when he was able-bodied. He certainly appreciated the conversation not being so "autobiographical" as he put it. A few mins later Mark told me the real reason why he was feeling so crap- he was constipated, so he had a really sore tummy and it was also affecting his BP. Furthermore, he'd spent the day filling out paperwork for an insurance claim regarding how he broke his ankle (he got hit by a car - for the third time), and he's really down about not being able to walk. I reckon he wouldn't have told this to just anyone and I'm glad he felt comfortable enough with me to tell me what was really going on. I modified a few of the exercises and made sure he got plenty of positive feedback, and thanked him for even rocking up today when he could have just stayed at home.
In hindsight I'm glad I picked up on Mark's unease when I did, and didn't question him for clarification in the begnnning. It did leave me a bit confused/ in the dark but it sorted itself out in the end and it minimised Mark's potential embarassment in front of his mates. He seems quite sensitive and I think that if I had confronted him or asked "why", it may have dented some of the trust we've built up. In the future I'll continue to trust my gut and empathise. I was lucky in this situation because I wasn't stressed for time... if I were up against the clock I'd definitely have been more firm, more rushed, and had less time to empathise fully with what he was going through.
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